Individual
MS. JENNIFER NIELLE WEBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.P.
Contact information
Practice address
834 98TH AVE NW, COON RAPIDS, MN 55433-5492
(763) 757-8282
(763) 757-8282
Mailing address
834 98TH AVE NW, COON RAPIDS, MN 55433-5492
(763) 757-8282
(763) 757-8282
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP4116
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125500 GRP # C613
OTHER
MN
05
—
380023700#
—
MN
Enumeration date
09/28/2006
Last updated
11/11/2020
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